Research Information System
SENDROM, vol.19, no.7, pp.20-33, 2007 (Scopus)
Body weight gain frequently occurs during drug treatment of psychiatric disorders and is often accompanied by increased appetite or food craving. While occurence and time course of this side effect are difficult to predict, it ultimately results in obesity and so, in a substantial part of the patients, often causing them to discontinue the treatment even if it is effective. This paper reviews the available epidemiological data on the frequency and extend of weight gain associated with antidepressant, mood-stabilizing and antipsychotic treatment. Possible underlying pathomechanisms and methabolic alterations are discussed with attention to central nervous control of appetite including the role of leptin and the tumor necrosis factor system. Weight gain appears to be most prominent in patients treated with some of the second generation antipsychotic drugs and with some mood stabilizers. Conventional antipsychotics typically induce only slight to moderate weight gain. Marked weight gain also frequently occurs during treatment with most tricyclic antidepressants. Seratonin reuptake inhibitors may induce weight loss during the first few weeks, but some of them induce weight gain during long term treatment. However, several antidepressant and antipsychotic drugs are identified which reliably do not cause weight gain or even reduce weight.